Casas Michael J, Kenny David J, Johnston Douglas H, Judd Peter L
The Hospital for Sick Children, Toronto, Ontario.
Pediatr Dent. 2004 Jan-Feb;26(1):44-8.
The purpose of this study was to compare long-term outcomes of ferric sulfate pulpotomy (FS) and primary tooth root canal therapy (RCT) in vital pulps of deciduous molars exposed to caries lesions.
A total of 291 molars were treated in 130 children. One hundred and eighty-two molars received FS and 109 received RCT by random selection.
At 3-year re-assessment, 29 molars (15 FS, 14 RCT) were available for clinical and radiographic examination. Two independent pediatric dentists evaluated periapical radiographs of the treated molars. Molars were classified 1 of 4 outcomes: (1) N = normal treated molar; (2) H = nonpathologic radiographic change present; (3) P(o) = pathologic change present, follow-up in 6 months; (4) P(x) = pathologic change present extract immediately. Survival analysis was applied. A good level of agreement between raters was found for molars with outcome P(x) (K = 0.79). No difference in radiographic outcomes was demonstrated 3 years after treatment (chi2 = 1.4). Survival analysis demonstrated a 3-year survival probability of 0.62 for FS-treated molars and 0.92 for RCT molars. Survival of RCT molars was significantly greater than for FS molars (Wilcoxon: P = .01; log-rank: P = .02).
RCT-treated molars demonstrated significantly greater survival than FS-treated molars 3 years after treatment.
本研究旨在比较硫酸铁牙髓切断术（FS）和乳牙根管治疗术（RCT）对暴露于龋损的乳磨牙活髓的长期治疗效果。
130名儿童共291颗磨牙接受治疗。通过随机选择，182颗磨牙接受FS治疗，109颗接受RCT治疗。
在3年的重新评估中，29颗磨牙（15颗FS治疗，14颗RCT治疗）可进行临床和影像学检查。两名独立的儿科牙医评估治疗后磨牙的根尖片。磨牙分为4种结果之一：（1）N = 治疗后正常的磨牙；（2）H = 存在非病理性影像学改变；（3）P(o) = 存在病理性改变，6个月后随访；（4）P(x) = 存在病理性改变，立即拔除。应用生存分析。对于结果为P(x)的磨牙，评估者之间有良好的一致性（K = 0.79）。治疗3年后，影像学结果无差异（χ2 = 1.4）。生存分析显示，FS治疗的磨牙3年生存概率为0.62，RCT治疗的磨牙为0.92。RCT治疗的磨牙生存率显著高于FS治疗的磨牙（Wilcoxon检验：P = 0.01；对数秩检验：P = 0.02）。
治疗3年后，RCT治疗的磨牙生存率显著高于FS治疗的磨牙。
